The Xtandi Factor

Part of my life this year has been spent on the road. While a couple of those sojourns have gone to the southland, most of those traveled miles have been within the northern part of California. And much of them have been to see my dad, who has been battling prostate and bone cancer for the last five and a half years. This time last year, my parents made a journey to my neck of the woods, seeing a doc at UCSF, where chemotherapy was advised. Taxotere was introduced into Dad’s retinue in late January, 2014. Suddenly this whole cancer-gig was more than the quarterly Lupron shot and doses of Zytiga, which not longer did the job.

And as it seems, just as speedily another year has passed. How many miles have been collected by my car, how many miles has my father trekked? Far more than I’ve traversed, for my dad isn’t the same. He might have been feeling on top of the world in late September, claiming he had another twenty-five years in the tank, but now in mid-December, he’s a different person. Radium 223 is still off the shelf, so Xtandi is the next option, a drug similar to Zytiga, taken in pill form. Dad will start Xtandi this week, and we’ll see if it helps, his PSA and overall demeanor our gauges. He’s also lost ten pounds since September, the chemo-style nausea having returned, without the chemo.

If you’ve never heard of any of these terms, no worries. Neither had I, until Dad was diagnosed, but the realm of cancer is like an alternate universe. We’ve been relatively fortunate; prostate cancer is quite treatable, and some men live for many years. But not all. Dad also has COPD, so that complicates matters. When he was first given this news, I wondered how he would cope with chemotherapy; he has an indefatigable spirit, but the body is a separate element. The doc at UCSF maintained that Taxotere is a milder form of chemo, compared to other drugs. And for the first seven rounds, Dad tolerated Taxotere like a champ. But in the eighth and ninth sessions, Taxotere came out with mean left hooks that left my father gripping the sides of the ring, wondering what in the hell had happened. There was no tenth dose; in early July, Dad was clearly on the ropes. But in late September, he had regained strength, his appetite, even his love of ice cream was returning. Another quarter century looked like a walk in the park.

Two and a half months later, those extra years seem fleeting. It makes me wonder about the nature of medical intervention, but more, I ponder if one day I am in a similar situation, what I would choose. Dad isn’t doing this all for himself; he’s doing it for Mom, their children and grandchildren. We all love him, want him to be around forever. But forever on this corporeal planet just doesn’t happen.

On other planes, yes. But not on Earth.

As Christmas approaches, I ask my husband and kids, “Okay, is there anything else you want?” We’re lucky, for tangible blessings are within our grasps. But the intangible aspects are all I wish for my father; to be pain-free, to be comfortable, to not be nauseous. I will never forget coming home from that UCSF appointment in a pouring Bay Area rain, traffic on I-280 at a standstill due to a nasty looking accident just south of San Francisco. My father’s impending date with chemo butted up against intense gratitude that my husband and I weren’t involved in that collision, that life and death were constantly battling for supremacy. One year later, I mull over that evening, so many nights and days in between, miles on motorways, a baby born, more on the way. And my father is still here, telling tales, also looking like a man I have never before seen. He is still my father, but no longer is he the strong, forceful character of past days.

Where Xtandi fits into all this remains to be seen. I hope it lowers the PSA, I hope it affords my dad some relief. But respite isn’t a cure. Through all of this, I have prayed for the will of God to be done. And every day that prayer has been answered. I don’t know why chemo left my father so debilitated, while his PSA bounced right back up as soon as Taxotere stopped being administered. But I do know that regardless of what Xtandi does or does not do, Dad will continue to chat and joke until he simply can’t. I’ll keep driving, as long as my car holds up. Blast the tunes, be they Christmas-themed or tropical pop; Dad’s still holding court. I’m ready for another road trip, on this concrete and ethereal pathway taking my father home.

Post navigation

2 thoughts on “The Xtandi Factor”

“But I do know that regardless of what Xtandi does or does not do, Dad will continue to chat and joke until he simply can’t. I’ll keep driving, as long as my car holds up. Blast the tunes, be they Christmas-themed or tropical pop; Dad’s still holding court. I’m ready for another road trip, on this concrete and ethereal pathway taking my father home.”